The limit is not physical; it is mental.

When we talk about stressful situations, we are generally talking about mental limits, blockades that slow us down or paralyze us completely. Government agencies, trade unions, institutions, and workers themselves denounce every day the assaults suffered by healthcare personnel. Violent acts toward healthcare center staff, out-of-hospital emergency teams, and security forces have increased significantly in recent years. This is evidenced by a recent survey conducted by the European Union, where 4% of professionals had suffered physical assaults on some occasion, and a high percentage reported having been victims of verbal and intimidating aggression.

This time, for the CPA training (Agitated/Aggressive Patient Control), we traveled to San Sebastián, where we trained professionals from Ambulancias Gipuzkoa in collaboration with EASO Politeknikoa. Violence in the healthcare environment is defined as a series of incidents that expose professionals to risks both for their physical and/or mental health and for their personal integrity and dignity. A large portion of the students report that when experiencing a stressful situation, decision-making becomes complicated. For this reason, we work with highly realistic role-playing and stress-filled scenarios so that participants learn to recognize and act under stress by learning to:

• Detect agitation early to anticipate and manage potentially risky situations of verbal or physical aggression.
• Acquire strategies aimed at redirecting hostile situations using verbal de-escalation as a primary measure.
• Learn about legislation and the protection of rights regarding restraint in healthcare facilities.
• Learn how to repel aggression and escape the scene.
• Learn our protocol for action in case of being cornered during home visits, in consulting rooms, or in ambulances.
• Learn defensive and physical restraint techniques.
• Learn how to perform emergency intranasal sedation in agitated patients.
• Learn how to manage stab and gunshot wounds.

We have had the pleasure of instructing healthcare professionals from the Basque Country and are truly delighted by the reception, energy, and attitude shown by the students.